I

104TH CONGRESS

1ST SESSION H. R. 2422

To amend title XVIII of the Social Security Act to provide for security

of the medicare program.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 28, 1995

Mr. MCDERMOTT (for himself, Mr. FORD, Mr. OLVER, Mr. DELLUMS, Mr.

TORRES, Mr. MOAKLEY, Mrs. CLAYTON, Mr. KLECZKA, Mr. SCOTT, Ms.

MCKINNEY, Ms. PELOSI, Mr. SPRATT, Mr. BARRETT of Wisconsin, Mr.

OWENS, Mr. FALEOMAVAEGA, Mr. YATES, Mr. VENTO, Mr. CONYERS,

Mr. MARTINEZ, Miss COLLINS of Michigan, Mr. GENE GREEN of Texas,

and Mr. WATT of North Carolina) introduced the following bill; which

was referred to the Committee on Ways and Means, and in addition to

the Committee on Commerce, for a period to be subsequently determined

by the Speaker, in each case for consideration of such provisions as fall

within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to provide

for security of the medicare program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Medicare Security Act of 1995’’.
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1 (b) TABLE OF CONTENTS.—The table of contents of

2 this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I—MEDICARE SECURITY COMMISSION

Sec. 101. Establishment of Medicare Security Commission.

Sec. 102. Duties.

Sec. 103. Membership.

Sec. 104. Staff and consultants.

Sec. 105. Powers.

Sec. 106. Report.

Sec. 107. Termination.

TITLE II—MEDICARE SAVINGS

Subtitle A—Savings in Medicare Part A

Sec. 201. Reductions in updates for inpatient hospital services subject to prospective payment system.

Sec. 202. Payment for ancillary costs of skilled nursing facilities under physician fee schedule.

Sec. 203. Maintaining savings resulting from temporary freeze on payment increases skilled nursing facility services.

Sec. 204. Continuation of reduction in payments for capital-related costs of inpatient hospital services.

Subtitle B—Savings in Medicare Part B

Sec. 211. Elimination of formula-driven overpayments for certain outpatient

hospital services.

Sec. 212. Continuing reduction in practice expense relative value units for certain services.

Sec. 213. Correction of MVPS upward bias.

Sec. 214. Application of competitive acquisition process for durable medical

equipment and clinical diagnostic laboratory tests.

Subtitle C—Savings in Parts A and B

Sec. 221. Extension of secondary payer data match requirements.

Sec. 222. Maintaining savings resulting from temporary freeze on payment increases for home health services.

Sec. 223. 6 percent reduction in AAPCC paid to medicare health maintenance

organizations.

Subtitle D—Transfers to Part A Trust Fund

Sec. 231. Transfer of amounts saved to Federal Hospital Insurance Trust

Fund.
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1 TITLE I—MEDICARE SECURITY

2 COMMISSION

3 SEC. 101. ESTABLISHMENT OF MEDICARE SECURITY COM4 MISSION.

5 There is established a commission to be known as the

6 Medicare Security Commission (in this Act referred to as

7 the ‘‘Commission’’).

8 SEC. 102. DUTIES.

9 The Commission shall make specific recommenda10 tions regarding revisions to the medicare program and

11 health care financing and coverage generally to assure the

12 continuing viability of the program during 2010 and there13 after when demographic changes are expected to expand

14 medicare’s enrollment significantly. Such revisions must

15 be designed in a manner that does not increase the num16 ber of uninsured or reduce access to care by program

17 beneficiaries or patients in general and does not increase

18 the financial obligations of current program beneficiaries,

19 including revisions to the methodology under which pay20 ments are made by the medicare program on behalf of

21 beneficiaries who are enrolled in private health care plans.

22 SEC. 103. MEMBERSHIP.

23 (a) APPOINTMENT.—

24 (1) IN GENERAL.—The Commission shall be

25 composed of seven members appointed by the Presi-
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1 dent, of whom two shall be appointed from a list of

2 nominees submitted by the President pro tempore of

3 the Senate (after consultation with the minority

4 leader of the Senate) and two shall be appointed

5 from among a list of nominees submitted by the

6 Speaker of the House of Representatives (after con7 sultation with the minority leader of the House of

8 Representatives). Not more than three members of

9 the Commission may be of the same political party.

10 (2) DEADLINE FOR APPOINTMENT AND

11 TERMS.—The members of the Commission shall be

12 appointed not later than December 1, 1995, and

13 shall serve for the life of the Commission.

14 (b) CHAIRMAN AND VICE CHAIRMAN.—The Commis15 sion shall elect a chairman and a vice chairman from

16 among its members.

17 (c) VACANCIES.—Any vacancy in the membership of

18 the Commission shall be filled in the manner in which the

19 original appointment was made and shall not affect the

20 power of the remaining members to execute the duties of

21 the Commission.

22 (d) QUORUM.—A quorum shall consist of five mem23 bers of the Commission, except that two members may

24 conduct a hearing under section 105(a).
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1 (e) MEETINGS.—The Commission shall meet at the

2 call of its chairman or a majority of its members.

3 (f) COMPENSATION AND REIMBURSEMENT OF EX4 PENSES.—Members of the Commission are not entitled to

5 receive compensation for service on the Commission. Mem6 bers may be reimbursed for travel, subsistence, and other

7 necessary expenses incurred in carrying out the duties of

8 the Commission.

9 SEC. 104. STAFF AND CONSULTANTS.

10 (a) STAFF.—The Commission may appoint and de11 termine the compensation of such staff as may be nec12 essary to carry out the duties of the Commission. Such

13 appointments and compensation may be made without re14 gard to the provisions of title 5, United States Code, that

15 govern appointments in the competitive services, and the

16 provisions of chapter 51 and subchapter III of chapter 53

17 of such title that relate to classifications and the General

18 Schedule pay rates.

19 (b) CONSULTANTS.—The Commission may procure

20 such temporary and intermittent services of consultants

21 under section 3109(b) of title 5, United States Code, as

22 the Commission determines to be necessary to carry out

23 the duties of the Commission.
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1 SEC. 105. POWERS.

2 (a) HEARINGS AND OTHER ACTIVITIES.—For the

3 purpose of carrying out its duties, the Commission may

4 hold such hearings and undertake such other activities as

5 the Commission determines to be necessary to carry out

6 its duties.

7 (b) STUDIES BY GENERAL ACCOUNTING OFFICE.—

8 Upon the request of the Commission, the Comptroller

9 General shall conduct such studies or investigations as the

10 Commission determines to be necessary to carry out its

11 duties.

12 (c) COST ESTIMATES BY CONGRESSIONAL BUDGET

13 OFFICE.—

14 (1) IN GENERAL.—Upon the request of the

15 Commission, the Director of the Congressional

16 Budget Office shall provide to the Commission such

17 cost estimates as the Commission determines to be

18 necessary to carry out its duties.

19 (2) REIMBURSEMENT.—The Commission shall

20 reimburse the Director of the Congressional Budget

21 Office for expenses relating to the employment in

22 the office of the Director of such additional staff as

23 may be necessary for the Director to comply with re24 quests by the Commission under paragraph (1).

25 (d) DETAIL OF FEDERAL EMPLOYEES.—Upon the

26 request of the Commission, the head of any Federal agen-
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1 cy is authorized to detail, without reimbursement, any of

2 the personnel of such agency to the Commission to assist

3 the Commission in carrying out its duties. Any such detail

4 shall not interrupt or otherwise affect the civil service sta5 tus or privileges of the Federal employee.

6 (e) TECHNICAL ASSISTANCE.—Upon the request of

7 the Commission, the head of a Federal agency shall pro8 vide such technical assistance to the Commission as the

9 Commission determines to be necessary to carry out its

10 duties.

11 (f) USE OF MAILS.—The Commission may use the

12 United States mails in the same manner and under the

13 same conditions as Federal agencies, and shall, for pur14 poses of the frank, be considered a commission of Con15 gress as described in section 3215 of title 39, United

16 States Code.

17 (g) OBTAINING INFORMATION.—The Commission

18 may secure directly from any Federal agency information

19 necessary to enable it to carry out its duties, if the infor20 mation may be disclosed under section 552 of title 5,

21 United States Code. Upon request of the Chairman of the

22 Commission, the head of such agency shall furnish such

23 information to the Commission.

24 (h) ADMINISTRATIVE SUPPORT SERVICES.—Upon

25 the request of the Commission, the Administrator of Gen-
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1 eral Services shall provide to the Commission on a reim2 bursable basis such administrative support services as the

3 Commission may request.

4 (i) ACCEPTANCE OF DONATIONS.—The Commission

5 may accept, use, and dispose of gifts or donations of serv6 ices or property.

7 SEC. 106. REPORT.

8 Not later than January 1, 1998, the Commission

9 shall submit to Congress a report containing its rec10 ommendations under section 102, and shall include in the

11 report recommendations for appropriate legislative initia12 tives to carry out its recommendations.

13 SEC. 107. TERMINATION.

14 The Commission shall terminate 30 days after the

15 date of submission of the report required in section 106.

16 TITLE II—MEDICARE SAVINGS

17 Subtitle A—Savings in Medicare

18 Part A

19 SEC. 201. REDUCTIONS IN UPDATES FOR INPATIENT HOS20 PITAL SERVICES SUBJECT TO PROSPECTIVE

21 PAYMENT SYSTEM.

22 Section 1886(b)(3)(B)(i) of the Social Security Act

23 (42 U.S.C. 1395ww(b)(3)(B)(i)) is amended—
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1 (1) in subclause (XI), by striking ‘‘fiscal year

2 1996’’ and inserting ‘‘fiscal years 1996 through

3 1999’’, and

4 (2) by striking subclauses (XII) and (XIII) and

5 inserting the following:

6 ‘‘(XII) for fiscal years 2000 through 2002, the

7 market basket percentage increase minus 1 percent8 age point for hospitals in all areas, and

9 ‘‘(XIII) for fiscal year 2003 and each subse10 quent fiscal year, the market basket percentage in11 crease for hospitals in all areas.’’.

12 SEC. 202. PAYMENT FOR ANCILLARY COSTS OF SKILLED

13 NURSING FACILITIES UNDER PHYSICIAN FEE

14 SCHEDULE.

15 (a) REQUIRING PAYMENT UNDER PART B TO BE

16 MADE UNDER PHYSICIAN FEE SCHEDULE.—

17 (1) IN GENERAL.—Section 1832(a)(2)(C) of the

18 Social Security Act (42 U.S.C. 1395k(a)(2)(C)) is

19 amended by striking the semicolon at the end and

20 inserting the following: ‘‘, other than services fur21 nished by a skilled nursing facility or by others

22 under arrangement with them made by the facility;’’.

23 (2) CLARIFICATION OF PAYMENT FOR SPEECH24 LANGUAGE PATHOLOGY SERVICES.—The fourth sen25 tence of section 1861(p) of such Act (42 U.S.C.
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1 1395x(p)) is amended by striking ‘‘outpatient,’’ and

2 inserting ‘‘outpatient or as an inpatient of an ex3 tended care facility,’’.

4 (b) CONFORMING AMENDMENT FOR SERVICES FUR5 NISHED UNDER PART A.—Section 1814 of such Act (42

6 U.S.C. 1395f) is amended—

7 (1) in subsection (b) in the matter preceding

8 paragraph (1)—

9 (A) by striking ‘‘and other than’’ and in10 serting ‘‘other than’’, and

11 (B) by striking ‘‘equipment)’’ and inserting

12 ‘‘equipment, and other than a skilled nursing

13 facility with respect to extended care services

14 described in section 1861(h)(3))’’; and

15 (2) by adding at the end the following new sub16 section:

17 ‘‘Payments to Skilled Nursing Facilities for Certain

18 Therapy Services

19 ‘‘(m) The amount paid to any skilled nursing facility

20 with respect to extended care services described in section

21 1861(h)(3) for which payment may be made under this

22 part shall be the amount determined pursuant to section

23 1833(a)(1)(N).’’.
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1 (c) EFFECTIVE DATE.—The amendments made by

2 this section shall apply to services furnished on or after

3 October 1, 1995.

4 SEC. 203. MAINTAINING SAVINGS RESULTING FROM TEM5 PORARY FREEZE ON PAYMENT INCREASES

6 SKILLED NURSING FACILITY SERVICES.

7 (a) BASING UPDATES TO PER DIEM COST LIMITS ON

8 LIMITS FOR FISCAL YEAR 1993.—

9 (1) IN GENERAL.—The last sentence of section

10 1888(a) of the Social Security Act (42 U.S.C.

11 1395yy(a)) is amended by adding at the end the fol12 lowing: ‘‘(except that such updates may not take

13 into account any changes in the routine service costs

14 of skilled nursing facilities occurring during cost re15 porting periods which began during fiscal year 1994

16 or fiscal year 1995).’’.

17 (2) NO EXCEPTIONS PERMITTED BASED ON

18 AMENDMENT.—The Secretary of Health and Human

19 Services shall not consider the amendment made by

20 paragraph (1) in making any adjustments pursuant

21 to section 1888(c) of the Social Security Act.

22 (b) PAYMENTS DETERMINED ON PROSPECTIVE

23 BASIS.—Any change made by the Secretary of Health and

24 Human Services in the amount of any prospective pay25 ment paid to a skilled nursing facility under section
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1 1888(d) of the Social Security Act for cost reporting peri2 ods beginning on or after October 1, 1995, may not take

3 into account any changes in the costs of services occurring

4 during cost reporting periods which began during fiscal

5 year 1994 or fiscal year 1995.

6 SEC. 204. CONTINUATION OF REDUCTION IN PAYMENTS

7 FOR CAPITAL-RELATED COSTS OF INPATIENT

8 HOSPITAL SERVICES.

9 Section 1886(g)(1)(A) of the Social Security Act (42

10 U.S.C. 1395ww(g)(1)(A)) is amended by striking

11 ‘‘through 1995’’ and inserting ‘‘through 2002’’.

12 Subtitle B—Savings in Medicare

13 Part B

14 SEC. 211. ELIMINATION OF FORMULA-DRIVEN OVERPAY15 MENTS FOR CERTAIN OUTPATIENT HOSPITAL

16 SERVICES.

17 (a) AMBULATORY SURGICAL CENTER PROCE18 DURES.—Section 1833(i)(3)(B)(i)(II) of the Social Secu19 rity Act (42 U.S.C. 1395l(i)(3)(B)(i)(II)) is amended—

20 (1) by striking ‘‘of 80 percent’’; and

21 (2) by striking the period at the end and insert22 ing the following: ‘‘, less the amount a provider may

23 charge as described in clause (ii) of section

24 1866(a)(2)(A).’’.
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1 (b) RADIOLOGY SERVICES AND DIAGNOSTIC PROCE2 DURES.—Section 1833(n)(1)(B)(i)(II) of such Act (42

3 U.S.C. 1395l(n)(1)(B)(i)(II)) is amended—

4 (1) by striking ‘‘of 80 percent’’; and

5 (2) by striking the period at the end and insert6 ing the following: ‘‘, less the amount a provider may

7 charge as described in clause (ii) of section

8 1866(a)(2)(A).’’.

9 (c) EFFECTIVE DATE.—The amendments made by

10 this section shall apply to services furnished during por11 tions of cost reporting periods occurring on or after Janu12 ary 1, 1996.

13 SEC. 212. CONTINUING REDUCTION IN PRACTICE EXPENSE

14 RELATIVE VALUE UNITS FOR CERTAIN SERV15 ICES.

16 (a) IN GENERAL.—Section 1848(c)(2)(E)(i) of the

17 Social Security Act (42 U.S.C. 1395w@4(c)(2)(E)(i)) is

18 amended—

19 (1) by striking ‘‘and’’ at the end of subclause

20 (II);

21 (2) by striking the period at the end of

22 subclause (III); and

23 (3) by adding at the end the following new

24 subclause:
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1 ‘‘(IV) 1997, by an additional 25

2 percent of such excess.’’.

3 (b) LOWERING FLOOR ON REDUCTIONS.—Section

4 1848(c)(2)(E)(ii) of such Act (42 U.S.C.

5 1395w@4(c)(2)(E)(ii)) is amended by striking ‘‘128 per6 cent’’ and inserting ‘‘120 percent’’.

7 (c) EFFECTIVE DATE.—The amendments made by

8 this section shall apply to physicians’ services furnished

9 on or after January 1, 1997.

10 SEC. 213. CORRECTION OF MVPS UPWARD BIAS.

11 (a) IN GENERAL.—Section 1848(f)(2)(A)(iv) of the

12 Social Security Act (42 U.S.C. 1395w–4(f)(2)(A)(iv)) is

13 amended by striking ‘‘including changes in law and regula14 tions affecting the percentage increase described in clause

15 (i)’’ and inserting ‘‘excluding anticipated responses to

16 such changes’’.

17 (b) EFFECTIVE DATE.—The amendment made by

18 subsection (a) shall apply with respect to performance

19 standard rates of increase determined for fiscal year 1996

20 and succeeding fiscal years.
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1 SEC. 214. APPLICATION OF COMPETITIVE ACQUISITION

2 PROCESS FOR DURABLE MEDICAL EQUIP3 MENT AND CLINICAL DIAGNOSTIC LABORA4 TORY TESTS.

5 (a) IN GENERAL.—Part B of title XVIII of the Social

6 Security Act is amended by inserting after section 1846

7 the following:

8 ‘‘COMPETITION ACQUISITION FOR CERTAIN ITEMS AND

9 SERVICES

10 ‘‘SEC. 1847. (a) ESTABLISHMENT OF BIDDING

11 AREAS.—

12 ‘‘(1) IN GENERAL.—The Secretary shall estab13 lish competitive acquisition areas for the purpose of

14 awarding a contract or contracts for the furnishing

15 under this part of the items and services described

16 in subsection (c) on or after January 1, 1997. The

17 Secretary may establish different competitive acqui18 sition areas under this subsection for different class19 es of items and services under this part.

20 ‘‘(2) CRITERIA FOR ESTABLISHMENT.—The

21 competitive acquisition areas established under para22 graph (1) shall—

23 ‘‘(A) initially be, or be within, metropolitan

24 statistical areas; and

25 ‘‘(B) be chosen based on the availability

26 and accessibility of suppliers and the probable
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1 savings to be realized by the use of competitive

2 bidding in the furnishing of items and services

3 in the area.

4 ‘‘(b) AWARDING OF CONTRACTS IN AREAS.—

5 ‘‘(1) IN GENERAL.—The Secretary shall con6 duct a competition among individuals and entities

7 supplying items and services under this part for

8 each competitive acquisition area established under

9 subsection (a) for each class of items and services.

10 ‘‘(2) CONDITIONS FOR AWARDING CONTRACT.—

11 The Secretary may not award a contract to any indi12 vidual or entity under the competition conducted

13 pursuant to paragraph (1) to furnish an item or

14 service under this part unless the Secretary finds

15 that the individual or entity—

16 ‘‘(A) meets quality standards specified by

17 the Secretary for the furnishing of such item or

18 service; and

19 ‘‘(B) offers to furnish a total quantity of

20 such item or service that is sufficient to meet

21 the expected need within the competitive acqui22 sition area.

23 ‘‘(3) CONTENTS OF CONTRACT.—A contract en24 tered into with an individual or entity under the

25 competition conducted pursuant to paragraph (1)
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1 shall specify (for all of the items and services within

2 a class)—

3 ‘‘(A) the quantity of items and services the

4 entity shall provide; and

5 ‘‘(B) such other terms and conditions as

6 the Secretary may require.

7 ‘‘(c) SERVICES DESCRIBED.—The items and services

8 to which the provisions of this section shall apply are as

9 follows:

10 ‘‘(1) Covered items under section 1834(a).

11 ‘‘(2) Clinical diagnostic laboratory tests.

12 ‘‘(3) Such other items and services for which

13 the Secretary determines that the use of competitive

14 acquisition under this section is appropriate and

15 cost-effective.’’.

16 (b) ITEMS AND SERVICES TO BE FURNISHED ONLY

17 THROUGH COMPETITIVE ACQUISITION.—Section 1862(a)

18 of such Act (42 U.S.C. 1395y(a)) is amended—

19 (1) by striking ‘‘or’’ at the end of paragraph

20 (14);

21 (2) by striking the period at the end of para22 graph (15) and inserting ‘‘; or’’; and

23 (3) by inserting after paragraph (15) the fol24 lowing new paragraph:
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1 ‘‘(16) where such expenses are for an item or

2 service furnished in a competitive acquisition area

3 (as established by the Secretary under section

4 1847(a)) by an individual or entity other than the

5 supplier with whom the Secretary has entered into

6 a contract under section 1847(b) for the furnishing

7 of such item or service in that area, unless the Sec8 retary finds that such expenses were incurred in a

9 case of urgent need.’’.

10 (c) REDUCTION IN PAYMENT AMOUNTS IF COMPETI11 TIVE ACQUISITION FAILS TO ACHIEVE MINIMUM REDUC12 TION IN PAYMENTS.—Notwithstanding any other provi13 sion of title XVIII of the Social Security Act, if the estab14 lishment of competitive acquisition areas under section

15 1847 of such Act (as added by subsection (a)) and the

16 limitation of coverage for items and services under part

17 B of such title to items and services furnished by providers

18 with competitive acquisition contracts under such section

19 does not result in a reduction of at least 10 percent in

20 the projected payment amount that would have applied to

21 the item or service under part B if the item or service

22 had not been furnished through competitive acquisition

23 under such section, the Secretary shall reduce the pay24 ment amount by such percentage as the Secretary deter25 mines necessary to result in such a reduction.
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1 (d) EFFECTIVE DATE.—The amendments made by

2 this section shall apply to items and services furnished on

3 or after January 1, 1997.

4 Subtitle C—Savings in Parts A and

5 B

6 SEC. 221. EXTENSION OF SECONDARY PAYER DATA MATCH

7 REQUIREMENTS.

8 (a) IN GENERAL.—Section 1862(b)(5)(C)(iii) of the

9 Social Security Act (42 U.S.C. 1395y(b)(5)(C)(iii)) is

10 amended by striking ‘‘1998’’ and inserting ‘‘2002’’.

11 (b) CONFORMING AMENDMENT.—Section

12 6103(l)(12) of the Internal Revenue Code of 1986 is

13 amended by striking ‘‘1998’’ and inserting ‘‘2002’’.

14 SEC. 222. MAINTAINING SAVINGS RESULTING FROM TEM15 PORARY FREEZE ON PAYMENT INCREASES

16 FOR HOME HEALTH SERVICES.

17 (a) BASING UPDATES TO PER VISIT COST LIMITS ON

18 LIMITS FOR FISCAL YEAR 1993.—Section

19 1861(v)(1)(L)(iii) of the Social Security Act (42 U.S.C.

20 1395x(v)(1)(L)(iii)) is amended by adding at the end the

21 following sentence: ‘‘In establishing limits under this sub22 paragraph, the Secretary may not take into account any

23 changes in the costs of the provision of services furnished

24 by home health agencies with respect to cost reporting pe-
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1 riods which began on or after July 1, 1994, and before

2 July 1, 1996.’’.

3 (b) NO EXCEPTIONS PERMITTED BASED ON AMEND4 MENT.—The Secretary of Health and Human Services

5 shall not consider the amendment made by subsection (a)

6 in making any exemptions and exceptions pursuant to sec7 tion 1861(v)(1)(L)(ii) of the Social Security Act.

8 SEC. 223. 6 PERCENT REDUCTION IN AAPCC PAID TO MEDI9 CARE HEALTH MAINTENANCE ORGANIZA10 TIONS.

11 (a) IN GENERAL.—Section 1876(a)(1)(C) of the So12 cial Security Act (42 U.S.C. 1395mm(a)(1)(C)) is amend13 ed by striking ‘‘95 percent’’ and inserting ‘‘89 percent’’.

14 (b) EFFECTIVE DATE.—The amendment made by

15 subsection (a) shall apply with respect to contracts entered

16 into or renewed under section 1876 of the Social Security

17 Act on or after the date of the enactment of this Act.

18 Subtitle D—Transfers to Part A

19 Trust Fund

20 SEC. 231. TRANSFER OF AMOUNTS SAVED TO FEDERAL

21 HOSPITAL INSURANCE TRUST FUND.

22 (a) IN GENERAL.—For each fiscal year, the Sec23 retary of the Treasury shall transfer to the Federal Hos24 pital Insurance Trust Fund under section 1817 of the So25 cial Security Act amounts equivalent to the Secretary of
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1 the Treasury’s estimate of the amount which would have

2 been expended from the Federal Supplementary Medical

3 Insurance Trust Fund under section 1841 of such Act

4 during such fiscal year but for the provisions of this title.

5 (b) TRANSFER RULES, ETC..—The provisions of sec6 tion 9602 of the Internal Revenue Code of 1986 shall

7 apply to transfers under this section.

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